Fixed Indemnity Insurance in Iowa

Fixed indemnity pays a set cash amount per covered event or hospital day regardless of the bill, a supplement to health insurance rather than a replacement for it. Iowa requires hospital indemnity to pay at least $40 a day for at least 31 days, regardless of other coverage.

At a glance

Fixed indemnity is available in Iowa as a supplemental, limited-benefit product, but Iowa sets specific requirements on it.
Hospital confinement indemnity must pay at least $40 per day for at least 31 days (IAC 191-36.6(4)), and benefits must be paid regardless of other coverage — Iowa also prescribes an Outline of Coverage in a "fixed daily benefit" format.
It pays a fixed cash amount per covered event or day, regardless of your actual costs — it doesn't work like major medical.
It's not ACA minimum essential coverage and not a substitute for a comprehensive plan. Iowa uses HealthCare.gov and has expanded Medicaid.

What Iowa requires

Iowa permits fixed indemnity as a supplemental, limited-benefit product, but it layers specific requirements on these plans. A hospital confinement indemnity plan must pay at least $40 per day for at least 31 days (IAC 191-36.6(4)), and benefits "shall be paid regardless of other coverage" (36.6(4)"b"). Iowa also prescribes an Outline of Coverage in a "fixed daily benefit" format (36.7(6)) so you can see exactly what the plan pays, and it bans the once-common exclusion for days covered under federal hospital-confinement programs (36.5(5)). The Iowa Insurance Division (part of the Iowa Department of Insurance and Financial Services) administers these rules.

Because fixed indemnity is an excepted benefit, it sits outside ACA rules. (At the federal level, a 2024 fixed-indemnity consumer-notice requirement was vacated by a court in December 2024, so it is not federally required; an earlier 2014 individual-market notice still applies.)

The core thing to understand is how it pays: fixed indemnity pays a predetermined cash amount when a covered event happens — no matter what your treatment actually costs. That's very different from major medical, which pays a share of your actual bills.

How fixed indemnity works in Iowa

Fixed indemnity and related excepted benefits come in a few forms (described as coverage types, not specific products):

Hospital indemnity — pays a fixed amount per hospital stay or per day admitted; in Iowa it must meet the state's per-day minimum and pay regardless of other coverage.
Accident coverage — pays fixed amounts for specified injuries or accident-related care.
Specified-disease or critical-illness coverage — pays a fixed benefit if you're diagnosed with a covered condition.

Each pays a fixed cash benefit you can use toward bills, deductibles, or everyday costs during a covered event. Iowa's prescribed Outline of Coverage lays the "fixed daily benefit" out plainly, so read that document closely. As an independent, carrier-neutral brokerage, we don't push any single insurer — and we'll be clear that fixed indemnity works best alongside a comprehensive plan, not instead of one.

How to get coverage here

Fixed indemnity isn't sold through the health insurance marketplace, and it isn't tied to Open Enrollment — you can generally apply for it year-round, directly from an insurer or through a broker, subject to the product's terms and Iowa's requirements.

For the comprehensive coverage that fixed indemnity is meant to supplement, Iowa uses the federally facilitated marketplace at HealthCare.gov, where ACA plans have an annual Open Enrollment (typically each fall through early winter) and Special Enrollment Periods for qualifying life events like losing job-based coverage, moving, or having a baby. Iowa has expanded Medicaid, so it's worth checking your eligibility there as well.

What it costs

We don't quote premiums here — prices depend on your situation — but the cost of fixed indemnity in Iowa is driven by:

The benefit amounts you choose — higher fixed payouts cost more; Iowa's per-day minimum sets a floor for hospital indemnity, but the level above that is up to you.
The type of product — hospital indemnity, accident, or specified-disease coverage.
Your age — older applicants generally pay more.
Who's covered — an individual or a family.
Any riders or add-ons you select.

Because fixed indemnity pays fixed amounts rather than a share of your bills, use the required Outline of Coverage to compare exactly what a plan pays — and remember it's supplemental, so weigh it alongside the cost of the comprehensive coverage it's meant to support.

MG Matthew T. Giberti Licensed Expert · NPN 20698856 · Updated July 2026

Fixed indemnity insurance is a supplemental, limited-benefit (excepted-benefit) product. It pays fixed cash amounts for covered events regardless of your actual medical costs, is not major medical coverage, and is not minimum essential coverage under the Affordable Care Act. It does not cover the full range of essential health benefits and is not a substitute for a comprehensive health plan.

GetHealthPlans.com is operated by MTG Insurance Agency, an independent, carrier-neutral brokerage. We do not issue insurance and are not a government agency or the health insurance marketplace. Regulatory details on this page reflect Iowa law and Iowa Insurance Division guidance as of the last-reviewed date and can change; confirm current terms and the specific product's approved form before you enroll.